Individual variations in ankle brachial index measurement among Turkish adults

Demir, Orhan; Taşçı, İlker; Açıkel, Cengizhan; Sağlam, Kenan; Gezer, Mustafa; Acar, Ramazan; Yıldız, Birol; Bulucu, Fatih; Kabul, Hasan Kutsi; Dogan, Mustafa Inanc; Koc, Bayram

doi:10.1177/1708538115584506

Cited by 11 publications

(24 citation statements)

References 25 publications

(32 reference statements)

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“…The majority of studies [12, 47–51, 55, 57] included only participants with suspected PAD, or risk factors for atherosclerosis; three studied a mixed population including those without risk factors or clinical indicators of PAD [13, 16, 52]; two studies included only participants with diabetes [53, 54], and two studies included only healthy individuals [46, 56].…”

Section: Resultsmentioning

confidence: 99%

The reliability of the ankle brachial index: a systematic review

Casey

Oldmeadow²,

Chuter

2019

Journal of Foot and Ankle Research

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Background The ankle brachial index (ABI) is widely used in clinical practice as a non-invasive method to detect the presence and severity of peripheral arterial disease (PAD). Current guidelines suggest that it should be used to monitor potential progression of PAD in affected individuals. As such, it is important that the test is reliable when used for repeated measurements, by the same or different health practitioners. This systematic review aims to examine the literature to evaluate the inter- and intra-rater reliability of the ABI. Methods A systematic search of MEDLINE, EMBASE and CINAHL Complete was conducted to 20 January 2019. Two authors independently reviewed and selected relevant studies and extracted the data. Methodological quality was determined using the Quality Appraisal of Reliability (QAREL) Checklist. Results Fifteen studies of ABI reliability in a range of patient populations were identified as suitable for inclusion in the review: seven considered inter-rater reliability, four intra-rater reliability, and four studies evaluated both inter- and intra-rater reliability. Inter-rater reliability was found to be highly variable, with intraclass correlation coefficients (ICC’s) ranging from poor to excellent (ICC 0.42–1.00), while intra-rater also demonstrated considerable variation, with ICCs from 0.42–0.98. Meta-analysis was not possible due to the lack of statistical information reported. Conclusions Results of included studies suggest the inter- and intra-tester reliability of the ABI is acceptable. However, inconsistencies in obtaining systolic pressure measurements, calculating ABI values, and incomplete reporting of methodologies and statistical analysis make it difficult to determine the validity of the results of included studies. Further research, with more consistent reliability methodology, statistical analysis and reporting conducted in populations at risk of PAD is needed to conclusively determine the ABI reliability.

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Section: Resultsmentioning

confidence: 99%

The reliability of the ankle brachial index: a systematic review

Casey

Oldmeadow²,

Chuter

2019

Journal of Foot and Ankle Research

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“…Methodological limitations related to ABI testing were unlikely in our study due to improved measurement facilities and the guideline recommended calculation of the ABI. However, apart from possible inter-test variations in ABI values obtained at different occasions (24), ABI measurement to diagnose lower extremity PAD may itself not be completely reliable in younger people at the age of early twenties. Although the ABI testing is successful to diagnose PAD (25), its angiographically tested sensitivity was found as low as 79% in different populations (26) and 82.3% in the original population of the study region (27).…”

Section: Discussionmentioning

confidence: 99%

Assessment of a low ankle brachial index in young males with congenital hypogonadism

Haymana¹,

Aydoğdu²,

Taşçı³

et al. 2017

Gulhane Med J

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Konjenital hipogonadizm bulunan genç erkek hastalarda düşük ayak bileği kol indeksinin değerlendirilmesi Kardiyometabolik hastalık sıklığı hipogonadizmde artmıştır. Periferik arter hastalığı (PAH) sistemik aterosklerozun bir manifestasyonu olup koroner arter hastalığı ve inme açısından iyi bir öngördürücüdür. Bu çalışmada tedavi almamış genç hipogonad hastalarda PAH sıklığının artıp artmadığı ve bu hastaların sistemik ateroskleroz açısından artmış riske sahip olup olmadıkları araştırılmıştır. Çalışmaya 49 konjenital hipogonadotropik hipogonadizm (KHH) hastası (ort. yaş: 21.82 ± 2.28 yıl) ve 37 sağlıklı olgu (ort. yaş: 22.34 ± 1.20 yıl) dahil edildi. Hasta ve sağlıklı kontrollerde plazma asimetrik dimetilarjinin (ADMA) ve yüksek duyarlılıklı C-reaktif protein (hs-CRP) düzeyleri ölçüldü. İnsülin direnci, homeostatic model assessment of insulin resistance (HOMA-IR) yöntemi ile hesaplandı. PAH, Doppler tekniği kullanılarak ölçülen ayak bileği kol indeksine (ABI) göre belirlendi. KHH hastalarında, sağlıklı kontrollerle karşılaştırıldığında daha yüksek total kolesterol (p=0.038), trigliserid (p=0.047), insulin (p<0.001), HOMA-IR skoru (p<0.001) ve ADMA (p<0.001) düzeyleri ve daha düşük vücut kitle indeksi (p=0.001) ve sistolik kan basıncı (p<0.007) düzeyleri tespit edildi. Ortalama ABI değerleri hastalarda 1.05 ± 0.13 ve sağlıklı kontrollerde 1.00 ± 0.10 (NS) olarak bulundu. Düşük ABI değerleri açısından bakıldığında hastaların %12.2'sinde ve kontrollerin %13.5'inde alt ekstremite PAH tespit edildi (NS). Bununla birlikte, regresyon analizinde çalışma parametrelerinin hiçbirinin düşük ABI düzeylerini predikte etmediği bulundu. Genç ve tedavi almamış KHH hastaları sağlıklı kontrollerle karşılaştırıldığında, endotheliyal disfonksiyon ve insulin direnci gibi metabolik bozukluklar açısından artmış riske sahip oldukları tespit edilirken düşük ABI açısından anlamlı farklılık tespit edilmedi. ABI ölçümü hipogonadizm bulunan genç erkeklerde PAH tespiti açısından duyarlı bir yöntem olmayabilir.

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“…The ABI is calculated according to the Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease II (TASC-II) guidelines 20 . The ABI is calculated by dividing the highest systolic blood pressure measured in each limb (anterior tibial artery or posterior tibial artery) to the highest systolic blood pressure measured in the right or left brachial artery 12 . An ABI < 0.90 is typically accepted to define PAD 11 .…”

Section: Methodsmentioning

confidence: 99%

“…Ankle-brachial index (ABI) is a non-invasive, simple, and routinely used test to diagnose and follow lower-extremity PAD, with a sensitivity of 90% and a specificity of 98% if the value is less than 0.9 11 , 12 . Guerchet et al suggested that a low ABI can be considered a marker of cognitive impairment 11 .…”

Section: Introductionmentioning

confidence: 99%

Association between ankle brachial index and development of postoperative intensive care unit delirium in patients with peripheral arterial disease

Kang

Jeon

et al. 2021

Sci Rep

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Patients with vascular diseases are prone to developing postoperative delirium (POD). Ankle brachial index (ABI) is a non-invasive clinical indicator of lower-extremities peripheral arterial disease (PAD) and has been identified as an indicator of cognitive impairment. We investigated the association between ABI and POD. 683 PAD patients who underwent elective leg arterial bypass surgery between October 1998 and August 2019 were collected for retrospective analysis. Demographic information, comorbidities, preoperative ABI and the Rutherford classification within one month prior to surgery were obtained. POD was assessed using the Confusion assessment method -intensive care unit. Logistic regression and receiver operating characteristics (ROC) curve analysis were used to assess the association between ABI and POD. The mean value of ABI was significantly lower in patients with POD than it was those without POD. Older age, more medical comorbidities, longer length of surgery, decreased ABI, and higher Rutherford class were all significantly associated with POD. The area under ROC (0.74) revealed that ABI below 0.35 was associated with development of POD. Lower preoperative ABI was associated with POD in PAD patients who underwent arterial bypass surgery.

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Individual variations in ankle brachial index measurement among Turkish adults

Abstract: Although reproducibility of ABI values was found satisfactory, up to 12% of participants displayed more than 0.15 alternations between measurements, either on the same day or more than a week apart.

Cited by 11 publications

References 25 publications

The reliability of the ankle brachial index: a systematic review

The reliability of the ankle brachial index: a systematic review

Assessment of a low ankle brachial index in young males with congenital hypogonadism

Association between ankle brachial index and development of postoperative intensive care unit delirium in patients with peripheral arterial disease

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